Provider Demographics
NPI:1558881037
Name:HICKORY FAMILY PHARMACY LLC.
Entity Type:Organization
Organization Name:HICKORY FAMILY PHARMACY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BATSHON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:828-324-4630
Mailing Address - Street 1:1501 TATE BLVD SE STE 102
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1385
Mailing Address - Country:US
Mailing Address - Phone:828-324-4630
Mailing Address - Fax:828-324-4675
Practice Address - Street 1:1501 TATE BLVD SE STE 102
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1385
Practice Address - Country:US
Practice Address - Phone:828-324-4630
Practice Address - Fax:828-324-4675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC131743336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy